Coaching Agreement with Susi Roos, RN, M.Div. Certified Professional Cancer Coach

Coaching Agreement with Susi Roos, RN, M.Div. Certified Professional Cancer Coach

Please check each section to show you understand and agree.
Entering your name in the Client Signature Box represents a signing of the agreement.

    • In-­‐home or hospital visits (within certain geographic parameters) if unable to make office visits. (Any additional fees will be determined by distance)
    • In-­‐person patient advocacy through accompanying patient on doctor’s visits, treatments or testing or other requested visits
    • In-­‐home visit for the purpose of evaluating environmental (home) safety/upgrading with regards to assessing “dirty electricity” or electromagnetic pollution, water quality, cleaning and self-­‐care products, kitchen appliances and foods, mattresses, etc.
    • Additional requested meetings with family members
    • Food preparation classes or demonstrations beyond what might be done within scheduled sessions
    • Exercise or kitchen equipment, monitoring devices or other products I choose for my body or home
    • Additional diagnostic nutritional lab testing (saliva, urine, stool and/or blood)
  • Entering your name in the Client Signature Box represents a signing of the agreement.